Physical examination maneuver

Physical Exam

Monofilament Testing

also known as Semmes-Weinstein monofilament test
🎬
Video coming September 2026

How to Perform

With the patient's eyes closed, apply a 10-gram (5.07) monofilament perpendicular to the skin at specified sites on the sole of the foot (commonly the plantar surface of the great toe and the metatarsal heads), pressing until the filament buckles into a C-shape, holding for 1-2 seconds, then releasing. Ask the patient to say when and where they feel it. Avoid callused skin, scars, and ulcers, and vary the timing so the patient cannot guess.

How to Interpret

Showing all 1 finding

Large-fiber Peripheral Neuropathy in Diabetes

Abnormal 10-g Semmes-Weinstein monofilament testing
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong

References

  • Wang F, Zhang J, Yu J, et al. Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis. J Diabetes Res. 2017;2017:8787261. doi:10.1155/2017/8787261. PubMed: 29119118
  • Semmes J, Weinstein S, Ghent L, Teuber HL. Somatosensory Changes After Penetrating Brain Wounds in Man. Cambridge, MA: Harvard University Press; 1960.

Related Bedside Tests

🎬Video coming Sept 2026
Vibratory Sensation
Rule in:HPeripheral Neuropathy, IELarge-fiber Peripheral Neuropathy in Diabetes
Rule out:VHPeripheral Neuropathy, IELarge-fiber Peripheral Neuropathy in Diabetes
🎬Video coming Sept 2026
Heel-to-shin
aka Heel-knee-shin test
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia (Posterior Column Dysfunction)
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia (Posterior Column Dysfunction)
🎬Video coming Sept 2026
Proprioception Toe Test
Rule in:HPeripheral Neuropathy, SHPeripheral Neuropathy (Large-fiber) or Dorsal Column Pathology
Rule out:VHPeripheral Neuropathy
🎬Video coming Sept 2026
Finger-to-nose
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IEUnilateral Cerebellar Lesion
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IEUnilateral Cerebellar Lesion
🎬Video coming Sept 2026
Gait Assessment
Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more
Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more
🎬Video coming Sept 2026
Romberg Test
aka Romberg sign
Rule in:IESensory Ataxia (Posterior Column Dysfunction), IETabes Dorsalis, IEVestibular Dysfunction (Uncompensated) +1 more
Rule out:IESensory Ataxia (Posterior Column Dysfunction), IETabes Dorsalis, IEVestibular Dysfunction (Uncompensated) +1 more